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Have developments in palliative care services impacted on place of death of colorectal cancer patients in Ireland? A population-based study

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Abstract

Background

Whether developments in palliative care have impacted on where cancer patients die is unknown. We investigated time trends in place of death for colorectal cancer.

Methods

Details were abstracted on 10,175 colorectal cancer deaths during 1994–2004. Time trends were analysed by joinpoint regression.

Results

Nearly half (49%) of deaths occurred in acute hospitals, 29% at home, 13% in hospices and 7% in nursing homes. Hospital deaths were unchanged over time. Hospice deaths rose from 6% in 1994 to 17% in 2003. Home deaths decreased significantly, but only in health boards with hospices [estimated annual percentage change (EAPC) = −3.6%, 95%CI −4.19 to −2.97%, p < 0.001]. Nursing home deaths rose significantly in areas without hospices (EAPC = 8.0%, 95%CI 2.27 to –13.94%, p = 0.011).

Conclusions

Most colorectal cancer deaths occur in hospital. Availability of hospice facilities is a key determinant of where the burden of death falls. The results suggest unmet demand for hospice care in Ireland.

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References

  1. National Cancer Registry (2007) Cancer in Ireland 1994–2005: a summary. National Cancer Registry, Cork

    Google Scholar 

  2. Verdecchia A, Guzzinati S, Francisci S, De Angelis R, Bray F, Allemani C, Tavilla A, Santaquilani M, Sant M, EUROCARE Working Group (2009) Survival trends in European cancer patients diagnosed from 1988 to 1999. Eur J Cancer 45:1042–1066

    Google Scholar 

  3. Carsin AE, Sharp L, Cronin-Fenton DP, Ó Céilleachair A, Comber H (2008) Inequity in colorectal cancer treatment and outcomes: a population-based study. Br J Cancer 22:266–274

    Article  Google Scholar 

  4. Beccaro M, Costantini M, Rossi PG, Miccinesi G, Grimaldi M, Bruzzi M (2006) Actual and preferred place of death of cancer patients. Results from the Italian survey of the dying of cancer (ISDOC). J Epidemiol Commun Health 60:412–416

    Article  Google Scholar 

  5. Higginson IJ, Sen-Gupta G (2000) Place of care in advanced cancer: a qualitative systematic review of patient preferences. J Palliat Med 3:287–300

    Article  CAS  PubMed  Google Scholar 

  6. Tiernan E, O’Connor M, O’Siorain L, Kearney M (2002) A prospective study of preferred versus actual place of death among patients referred to a palliative care home-care service. Ir Med J 95:232–235

    CAS  PubMed  Google Scholar 

  7. Burge FI, Lawson B, Johnston G, Flowerdew G (2005) Health care restructuring and family physician care for those who died of cancer. BMC Fam Pract 6:1

    Article  PubMed  Google Scholar 

  8. Gomes B, Higginson IJ (2006) Factors influencing death at home in patients terminally ill with cancer: systematic review. BMJ 332:515–521

    Article  PubMed  Google Scholar 

  9. Davison D, Johnston G, Reilly P, Stevenson M (2001) Where do patients with cancer die in Belfast? Ir J Med Sci 170:18–23

    Article  CAS  PubMed  Google Scholar 

  10. Davies E, Linklater KM, Jack RH, Clark L, Moller H (2006) How is place of death from cancer changing and what affects it? Analysis of cancer registration and service data. Br J Cancer 95:593–600

    Article  CAS  PubMed  Google Scholar 

  11. Hunt RW, Fazekas BS, Luke CG, Roder DM (2001) Where patients with cancer die in South Australia, 1990–1999: a population-based review. Med J Aust 175:526–529

    CAS  PubMed  Google Scholar 

  12. Neutel CI, Bishop ML, Harper SD, Gaudette LA (2005) Proportion of cancer deaths occurring in hospital, Canada, 1994–2000. Can J Public Health 96:264–268

    PubMed  Google Scholar 

  13. Department of Health (1994) Shaping a healthier future: a strategy for effective healthcare in the 1990s. Department of Health, Dublin

    Google Scholar 

  14. Department of Health and Children (2001) Quality and fairness: a health system for you. Department of Health and Children, Dublin

    Google Scholar 

  15. Irish Hospice Foundation (2006) A baseline study on the provision of hospice/specialist palliative care services in Ireland. Irish Hospice Foundation, Dublin

    Google Scholar 

  16. Bruera E, Neumann C, Gagnon B et al (1999) Edmonton regional palliative care program: impact on patterns of terminal cancer care. CMAJ 161:290–293

    CAS  PubMed  Google Scholar 

  17. Kim HJ, Fay MP, Feuer EJ, Midthune DN (2000) Permutation tests for joinpoint regression with applications to cancer rates. Stat Med 19:335–351

    Article  CAS  PubMed  Google Scholar 

  18. World Health Organisation, Europe. Palliative care. The solid facts. http://www.euro.who.int/document/E82931.pdf. Accessed Dec 2009

  19. Ling S, Ó Síoráin L (2005) Palliative care in Ireland. Open University Press, New York

    Google Scholar 

  20. Gatrell AC, Harman JC, Francis BJ, Thomas C, Morris SM, McIllmurray M (2003) Place of death: analysis of cancer deaths in part of North West England. J Public Health Med 25:53–58

    Article  PubMed  Google Scholar 

  21. Aabom B, Kragstrup J, Vondeling H, Bakketeig LS, Støvring H (2005) Population-based study of place of death of patients with cancer: implications for GPs. Br J Gen Pract 518:684–689

    Google Scholar 

  22. Higginson IJ, Astin P, Dolan S (1998) Where do cancer patients die? Ten-year trends in the place of death of cancer patients in England. Palliat Med 12:353–363

    Article  CAS  PubMed  Google Scholar 

  23. Hays JC (1986) Patient symptoms and family coping. Predictors of hospice utilization patterns. Cancer Nurs 9:317–325

    Article  CAS  PubMed  Google Scholar 

  24. Herd EB (1990) Terminal care in a semi-rural area. Br J Gen Pract 40:248–251

    CAS  PubMed  Google Scholar 

  25. Townsend J, Frank AO, Fermont D et al (1990) Terminal cancer care and patients’ preference for place of death: a prospective study. BMJ 301:415–417

    Article  CAS  PubMed  Google Scholar 

  26. Hinton J (1994) Which patients with terminal cancer are admitted from home care? Palliat Med 8:197–210

    Article  CAS  PubMed  Google Scholar 

  27. Seamark DA, Thorne CP, Lawrence C, Gray DJ (1995) Appropriate place of death for cancer patients: views of general practitioners and hospital doctors. Br J Gen Pract 45:359–363

    CAS  PubMed  Google Scholar 

  28. Canadian Institute for Health Information, Ottawa (2002) Health care in Canada. http://secure.cihi.ca/cihiweb/products/HR2002eng.pdf. Accessed Dec 2009

  29. Hearn J, Higginson IJ (1998) Do specialist palliative care teams improve outcomes for cancer patients? A systematic literature review of the evidence. Palliat Med 12:317–332

    Article  CAS  PubMed  Google Scholar 

  30. Yabroff KR, Davis WW, Lamont EB et al (2007) Patient time costs associated with cancer care. J Natl Cancer Inst 99:14–23

    Article  PubMed  Google Scholar 

  31. Yabroff KR, Kim Y (2009) Time costs associated with informal caregiving for cancer survivors. Cancer 115(18 Suppl):4362–4373

    Article  PubMed  Google Scholar 

  32. Sharp L, Timmons A (2010) The financial impact of a cancer diagnosis. National Cancer Registry/Irish Cancer Society, Cork

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Acknowledgments

The authors are grateful to the Central Statistics Office for the provision of information from death certificates. This study was funded by a grant from the Health Research Board, Dublin.

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Authors and Affiliations

  1. National Cancer Registry, Building 6800, Cork Airport Business Park, Kinsale Road, Cork, Ireland

    A. Ó Céilleachair, S. Deady, A.-E. Carsin & L. Sharp

  2. Department of Nursing, Dublin City University, Dublin, Ireland

    C. Finn

Authors
  1. A. Ó Céilleachair
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  2. C. Finn
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  3. S. Deady
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  4. A.-E. Carsin
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  5. L. Sharp
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Correspondence to L. Sharp.

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Ó Céilleachair, A., Finn, C., Deady, S. et al. Have developments in palliative care services impacted on place of death of colorectal cancer patients in Ireland? A population-based study. Ir J Med Sci 180, 91–96 (2011). https://doi.org/10.1007/s11845-010-0607-y

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  • DOI: https://doi.org/10.1007/s11845-010-0607-y

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